Hearing Test

What are hearing tests?

Hearing tests are how healthcare providers determine if you have hearing loss. You may have several hearing tests in your lifetime. Babies and children in the U.S. have hearing screening tests. Experts estimate that more than 30 million Americans age 18 and older have some trouble hearing. Hearing tests are how people can find out if they have hearing loss. There are different kinds of hearing tests that use different techniques to identify hearing loss. One common test uses audiometry and the audiogram to identify hearing loss and show test results. Hearing tests don’t require special preparation and don’t hurt.

What are hearing tests called?

Hearing tests may be hearing screenings or hearing evaluations. If you have a hearing screening, you’re having a test to see if you have normal hearing. If you fail a hearing screening, you should then have a full hearing evaluation or audiologic evaluation. Audiologists do hearing evaluations to learn the type of hearing loss you have and if your hearing loss is mild, moderate or severe.

Who should have a hearing test?

Most people in the U.S. will have a hearing screening or hearing evaluation during their lifetime. Babies born in the U.S. usually have hearing screenings right after they’re born. Children may have hearing screenings as part of their well-child appointments or at school. They may have hearing tests if they appear to have trouble hearing. Most adults have hearing tests because they’re having trouble hearing or because people around them notice they’re having trouble hearing.

How often should I have a hearing test?

That depends on your situation. For example, if your job is in a noisy work environment, you may need your hearing checked once a year. If you don’t, you may not need a hearing evaluation until you’re in your 50s or 60s. That’s when many people start having age-related hearing loss. If you think you’re having trouble hearing, ask a healthcare provider about hearing evaluations. They may refer you to an audiologist for a formal hearing evaluation.

What are the types of hearing tests?

There are several types of hearing tests. Some tests are typically used to check adults’ hearing and others are used for babies, children and adults. Hearing test types include:

• Pure-tone testing: This common hearing test finds the quietest volume you can hear at each pitch. Children and adults have pure-tone testing.
• Bone conduction testing: This test is used to see if you have wax or fluid blocking your outer ear or middle ear, or if hearing loss is present in the sensory cells of hearing.
• Speech testing: Adults and some children may have this kind of hearing test. Speech testing involves listening to and repeating certain words. The test shows how you understand speech.
• Auditory brainstem response (ABR): This test checks the connections or pathways between your inner ear and brain. Audiologists may use this test to check hearing in children and people who can’t complete pure-tone tests. They may also use this test for people who have a brain injury that affects their hearing.
• Otoacoustic emissions test (OAE): Audiologists use this test to check your inner ear function.
• Tympanometry: This test checks how well your eardrum moves. Audiologists may do tympanometry tests to see if you have a ruptured eardrum, if you have fluid in your middle ear or wax in your ear canal.

Who performs hearing tests?

Healthcare providers may do hearing screenings. Audiologists do hearing tests.

How do I test my hearing at home?

There are many at-home hearing tests for you to consider. At-home tests may indicate you have hearing issues. To find out what’s wrong — and to get help — you should have a hearing evaluation done by an audiologist.

How do hearing tests work?

There are several kinds of hearing tests, from tests to see how well you hear to tests to see if you have something blocking your ear.

Pure-tone hearing test

This is the most common hearing test. Here’s how it works:

1. You sit in a sound-treated room.
2. You wear headphones or insert earphones.
3. The audiologist uses a machine called an audiometer. Audiometers deliver sounds at different frequencies and loudness levels.
4. You raise a hand, press a button or say “yes” when you hear sounds.
5. The audiologist records your responses on an audiogram. Audiograms chart your hearing loss patterns. If you have hearing loss, the audiogram shows the degree of hearing loss you have.

Bone conduction testing

Audiologists use this test to determine if there’s wax or fluid buildup that may be blocking your middle or outer ear, or if hearing loss is present in the sensory cells of the hearing organ. The test also shows the audiologist how well you hear.

1. The audiologist puts a small device behind your ear or on your forehead.
2. They send sounds through the device. Those sounds make your skull vibrate very gently.
3. The vibration skips your outer and middle ear and goes to your inner ear.

Speech testing

Your audiologist may do a speech test along with a pure-tone test. Speech tests evaluate your ability to listen to words and repeat them.

1. Like the pure-tone test, you wear headphones or insert earphones.
2. Your audiologist will say words in softer and louder sound levels.
3. You’ll repeat the words your audiologist says.
4. Your audiologist will record the softest speech you can repeat.
5. They may also ask you to repeat words spoken at a louder level to test your word recognition.

Auditory brainstem response (ABR)

This test checks the connections or pathways between your inner ear and brain. Unlike a pure-tone test, you don’t need to respond to sounds. You do need to stay still during the test.

1. You wear earphones for this test.
2. Your audiologist puts electrodes on your head. The electrodes stick to your skin and connect to a computer.
3. The electrodes record your brainwave activity as your brain responds to certain sounds played through the earphones.
4. The computer records your brainwave activity. Your audiologist reviews computer printouts to see your test results.

Otoacoustic emissions test (OAE)

This test checks your inner ear function. It does that by measuring otoacoustic emissions (OAEs). OAEs are sounds your inner ear produces when it responds to sound. (Recall that sound starts in your outer ear and travels through your middle, then your inner ear.) Tiny hair cells in your inner ear vibrate when sound waves hit them. The hair cell vibrations make a very quiet sound that echoes in your middle ear. That’s the sound OAEs measure. If you have hearing loss, your inner ear won’t produce OAEs.

1. Your audiologist places a small earphone or probe in your ear.
2. The probe puts sound into your ear and measures the sounds that come back.
3. Your test results show up on a monitor.

Tympanometry

Your eardrum is a flexible barrier that separates your outer ear from your middle ear. When sound from your outer ear hits your eardrum, your eardrum vibrates. Those vibrations travel through your middle and inner ear, triggering signals that go to your brain. Your brain translates those signals into sound. Tympanometry shows if your eardrum responds to air pushed into your ear.

1. Your audiologist puts a small probe in your ear. The probe may look like an earphone or earbud.
2. A small device attached to the probe pushes air into your ear.
3. The device has a graph called a tympanogram that registers eardrum movement.
4. The graph shows your audiologist how your eardrum moves.

When do I get my hearing test results?

In general, your audiologist will share your test results with you right away.

What happens after that?

That depends on your situation. For example, if one of the tests shows wax or fluid blocking your middle ear, they may refer you to an ear, nose and throat (ENT) specialist to remove the wax or fluid. Or if your pure-tone hearing test shows you have hearing loss, your audiologist will tell you:

• If you have mild, moderate or severe hearing loss.
• What hearing devices may help you hear. For example, they may tell you about different kinds of hearing aids. They may talk about hearing assistance like cochlear implants.
• They’ll tell you what you can expect when you use specific hearing devices.
• If you choose hearing aids, your audiologist will select and fit your hearing aids.
• If your audiologist recommends you consider cochlear implants, they’ll schedule you for further testing and evaluation.

A note from Cleveland Clinic

Hearing tests are how you find out if you have hearing loss. If you do, you’re not alone. More than 30 million people in the U.S. report they have some trouble hearing. The most common type of hearing loss happens over time. You may not notice you’re losing your hearing, but you may realize you can’t understand what people are saying. A hearing test done by an audiologist is the best way to find out if you have hearing loss. If you’re concerned about your ability to hear, ask a primary care provider if they can recommend an audiologist to help you.